Periodico online di SICOOP – 16/04

Female recreational skiers have twice the rate of knee injuries and three time the rate of ACL injuries compared with their male counterparts. Female skiers suffering from a knee injury reported a significantly higher proportion of failure of binding release than knee injured male skiers. Among a cohort of 498 recreational skiers (68% females) suffering from an ACL injury (complete rupture or partial rupture), age, sex, height, weight, self-reported skill level and self-reported risk taking behaviour, gear origin, ski length, date of last binding adjustment, perceived speed at the moment of injury, type of fall, and failure of binding release of the ski of the injured knee, were collected by questionnaire. Among this cohort of ACL-injured skiers, failure of binding release was significantly associated with female sex, a slow perceived speed at the moment of injury and complete rupture of the ACL. more …

Periprosthetic joint infection (PJI) is a significant challenge to the orthopedic surgeon, patient, hospital, and insurance provider. An in-house retrospective financial review of all patients who underwent 2-stage revision hip or knee arthroplasty for infection between January 2008 and August 2013, comparing self-originating and referral cases has benn evaluated. With referral centers treating increased numbers of infected joints performed elsewhere, we show continued financial incentive in accepting referrals, although with less financial gain than when treating one's own hip PJI and an increased financial gain when treating referral knee PJIs. more …

Hypoplastic Metatarsals – Beyond Cosmesis

Hypoplastic metatarsals, or idiopathic brachymetatarsia, is a relatively frequent diagnosis in podiatric practice. Patients with this abnormality typically seek surgery because of cosmetic concerns, difficulty wearing shoes, or foot discomfort. Hypoplastic metatarsals may be accompanied by other physical features, most often related to Albright's hereditary osteodystrophy. When findings indicative of Albright's hereditary osteodystrophy are present in conjunction with laboratory abnormalities, pseudohypoparathyroidism type 1a is the likely diagnosis. However, the case we describe here shows that isolated hypoplastic metatarsals can be the initial presentation of pseudohypoparathyroidism type 1b. more …

Isolated fractures of the greater trochanter (GT) of the femur are uncommon and few studies have assessed the diagnosis and appropriate therapeutic schedule for these fractures. A systematic review of published studies that evaluated patients who displayed isolated GT fracture on routine radiographic examination and underwent a magnetic resonance imaging (MRI) scan because of the suspicion of extension into the intertrochanteric region is described. The study has helped to elucidate further the assessment of isolated fracture of the GT. We believe that MRI is a reasonable option for patients presenting with isolated GT fracture on plain radiographs. more …

The inferior capsular-shift procedure for multidirectional instability of the shoulder.

Thirty-eight patients (forty-three shoulders) who had disabling multidirectional instability of the shoulder were managed with an inferior capsular-shift procedure through an anterior approach. It was our experience that if non-operative treatment of multidirectional instability of the shoulder failed, the inferior capsular-shift procedure provided satisfactory objective and subjective results. Failures and recurrences of symptomatic instability occurred early in the postoperative period. There appeared to be no deterioration of the results with follow-up to seventy-one months. more …